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Organization

MOORESVILLE PHARMACY EAST, LLC

Active
Parent organization
MOORESVILLE PHARMACY EAST LLC
Other names
HEALTHSMART PHARMACY
Organization subpart
Yes

Provider details

NPI number
Legal business name
MOORESVILLE PHARMACY EAST LLC
Authorized official
GAVIN MICHAEL HOUCHINS PHARM.D (OWNER)
(704) 799-6872
Entity
Organization

Contact information

Practice address
594 N MAIN ST, MOORESVILLE, NC 28115-2328
(704) 799-6870
Mailing address
594 N MAIN ST, MOORESVILLE, NC 28115-2328
(704) 799-6870

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0497129
NC
05
7N7707
SC
Enumeration date
10/30/2018
Last updated
10/30/2018
About Stedi
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  • EDI platform